Development of a nomogram for predicting pancreatic portal hypertension in patients with acute pancreatitis: a retrospective study

Pancreatic portal hypertension (PPH) is a rare complication of acute pancreatitis (AP) that can lead to severe gastrointestinal bleeding. The risk factors associated with PPH, as well as the overall prognosis, warrant further investigation. This study aims to develop and validate a nomogram to predi...

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Bibliographic Details
Published in:BMJ open gastroenterology 2024-11, Vol.11 (1), p.e001539
Main Authors: Zhang, Yingjie, Su, Qiaoyu, Li, Yunling, Zhan, Xianchen, Wang, XiangPing, Zhang, Linhui, Luo, Hui, Kang, Xiaoyu, Lv, Yong, Liang, Shuhui, Ren, Gui, Pan, Yanglin
Format: Article
Language:English
Subjects:
Acute Disease
Adult
Aged
Biliary and Pancreatic Disease
Body Mass Index
Female
Gastrointestinal Hemorrhage - diagnosis
Gastrointestinal Hemorrhage - etiology
Humans
Hypertension, Portal - complications
Hypertension, Portal - diagnosis
Male
Middle Aged
Nomograms
Original Research
Pancreatitis - complications
Pancreatitis - diagnosis
Predictive Value of Tests
Prognosis
Retrospective Studies
Risk Factors
ROC Curve
Tomography, X-Ray Computed
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Summary:Pancreatic portal hypertension (PPH) is a rare complication of acute pancreatitis (AP) that can lead to severe gastrointestinal bleeding. The risk factors associated with PPH, as well as the overall prognosis, warrant further investigation. This study aims to develop and validate a nomogram to predict PPH in patients with AP. Consecutive patients with AP from 2015 to 2023 were retrospectively included in the study. Demographic data, clinical manifestations within the first week of AP onset, and initial contrast-enhanced CT findings were used to develop the predictive model. Univariate and multivariate Cox regression analyses were performed to identify risk factors for PPH. Based on the results of the multivariate analysis, a nomogram was developed. The patients were randomly divided into training and validation sets at a 7:3 ratio. The accuracy and discriminative power of the predictive model were assessed using the area under the curve (AUC) from the receiver operating characteristic curve and the calibration curve. Of the 1473 patients with AP, 107 (7.3%) developed PPH within 6 months (range: 2-22 months) during follow-up. Multivariate regression analysis showed that body mass index (BMI) (HR, 1.10; 95% CI 1.04 to 1.16; p=0.001), moderately severe grade (HR, 9.36; 95% CI 4.58 to 19.13; p
ISSN:2054-4774
2054-4774
DOI:10.1136/bmjgast-2024-001539